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Yildirim O, Peck KK, Saha A, Karimi S, Lis E. Dynamic Contrast Enhanced MR Perfusion and Diffusion-Weighted Imaging of Marrow-Replacing Disorders of the Spine: A Comprehensive Review. Radiol Clin North Am 2024; 62:287-302. [PMID: 38272621 DOI: 10.1016/j.rcl.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Significant advancements in cancer treatment have led to improved survival rates for patients, particularly in the context of spinal metastases. However, early detection and monitoring of treatment response remain crucial for optimizing patient outcomes. Although conventional imaging methods such as bone scan, PET, MR imaging, and computed tomography are commonly used for diagnosing and monitoring treatment, they present challenges in differential diagnoses and treatment response monitoring. This review article provides a comprehensive overview of the principles, applications, and practical uses of dynamic contrast-enhanced MR imaging and diffusion-weighted imaging in the assessment and monitoring of marrow-replacing disorders of the spine.
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Affiliation(s)
- Onur Yildirim
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| | | | - Atin Saha
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Sasan Karimi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Eric Lis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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Obuchowicz R, Nurzynska K, Pierzchala M, Piorkowski A, Strzelecki M. Texture Analysis for the Bone Age Assessment from MRI Images of Adolescent Wrists in Boys. J Clin Med 2023; 12:jcm12082762. [PMID: 37109098 PMCID: PMC10141677 DOI: 10.3390/jcm12082762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
Currently, bone age is assessed by X-rays. It enables the evaluation of the child's development and is an important diagnostic factor. However, it is not sufficient to diagnose a specific disease because the diagnoses and prognoses may arise depending on how much the given case differs from the norms of bone age. BACKGROUND The use of magnetic resonance images (MRI) to assess the age of the patient would extend diagnostic possibilities. The bone age test could then become a routine screening test. Changing the method of determining the bone age would also prevent the patient from taking a dose of ionizing radiation, making the test less invasive. METHODS The regions of interest containing the wrist area and the epiphyses of the radius are marked on the magnetic resonance imaging of the non-dominant hand of boys aged 9 to 17 years. Textural features are computed for these regions, as it is assumed that the texture of the wrist image contains information about bone age. RESULTS The regression analysis revealed that there is a high correlation between the bone age of a patient and the MRI-derived textural features derived from MRI. For DICOM T1-weighted data, the best scores reached 0.94 R2, 0.46 RMSE, 0.21 MSE, and 0.33 MAE. CONCLUSIONS The experiments performed have shown that using the MRI images gives reliable results in the assessment of bone age while not exposing the patient to ionizing radiation.
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Affiliation(s)
- Rafal Obuchowicz
- Department of Diagnostic Imaging, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Karolina Nurzynska
- Department of Algorithmics and Software, Silesian University of Technology, 44-100 Gliwice, Poland
| | | | - Adam Piorkowski
- Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland
| | - Michal Strzelecki
- Institute of Electronics, Lodz University of Technology, 93-590 Lodz, Poland
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Rashidi A, Baratto L, Theruvath AJ, Greene EB, Jayapal P, Hawk KE, Lu R, Seekins J, Spunt SL, Pribnow A, Daldrup-Link HE. Improved Detection of Bone Metastases in Children and Young Adults with Ferumoxytol-enhanced MRI. Radiol Imaging Cancer 2023; 5:e220080. [PMID: 36999999 PMCID: PMC10077085 DOI: 10.1148/rycan.220080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 01/25/2023] [Accepted: 02/10/2023] [Indexed: 04/12/2023]
Abstract
Purpose To evaluate if ferumoxytol can improve the detection of bone marrow metastases at diffusion-weighted (DW) MRI in pediatric and young adult patients with cancer. Materials and Methods In this secondary analysis of a prospective institutional review board-approved study (ClinicalTrials.gov identifier NCT01542879), 26 children and young adults (age range: 2-25 years; 18 males) underwent unenhanced or ferumoxytol-enhanced whole-body DW MRI between 2015 and 2020. Two reviewers determined the presence of bone marrow metastases using a Likert scale. One additional reviewer measured signal-to-noise ratios (SNRs) and tumor-to-bone marrow contrast. Fluorine 18 (18F) fluorodeoxyglucose (FDG) PET and follow-up chest CT, abdominal and pelvic CT, and standard (non-ferumoxytol enhanced) MRI served as the reference standard. Results of different experimental groups were compared using generalized estimation equations, Wilcoxon rank sum test, and Wilcoxon signed rank test. Results The SNR of normal bone marrow was significantly lower at ferumoxytol-enhanced MRI compared with unenhanced MRI at baseline (21.380 ± 19.878 vs 102.621 ± 94.346, respectively; P = .03) and after chemotherapy (20.026 ± 7.664 vs 54.110 ± 48.022, respectively; P = .006). This led to an increased tumor-to-marrow contrast on ferumoxytol-enhanced MRI scans compared with unenhanced MRI scans at baseline (1397.474 ± 938.576 vs 665.364 ± 440.576, respectively; P = .07) and after chemotherapy (1099.205 ± 864.604 vs 500.758 ± 439.975, respectively; P = .007). Accordingly, the sensitivity and diagnostic accuracy for detecting bone marrow metastases were 96% (94 of 98) and 99% (293 of 297), respectively, with the use of ferumoxytol-enhanced MRI compared with 83% (106 of 127) and 95% (369 of 390) with the use of unenhanced MRI. Conclusion Use of ferumoxytol helped improve the detection of bone marrow metastases in children and young adults with cancer. Keywords: Pediatrics, Molecular Imaging-Cancer, Molecular Imaging-Nanoparticles, MR-Diffusion Weighted Imaging, MR Imaging, Skeletal-Appendicular, Skeletal-Axial, Bone Marrow, Comparative Studies, Cancer Imaging, Ferumoxytol, USPIO © RSNA, 2023 ClinicalTrials.gov registration no. NCT01542879 See also the commentary by Holter-Chakrabarty and Glover in this issue.
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Affiliation(s)
- Ali Rashidi
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Lucia Baratto
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Ashok Joseph Theruvath
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Elton Benjamin Greene
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Praveen Jayapal
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - K. Elizabeth Hawk
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Rong Lu
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Jayne Seekins
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Sheri L. Spunt
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Allison Pribnow
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
| | - Heike E. Daldrup-Link
- From the Department of Radiology, Molecular Imaging Program at
Stanford (A.R., L.B., A.J.T., K.E.H., J.S., H.E.D.L.), and Department of
Radiology, Division of Pediatric Radiology (E.B.G., P.J.), Lucile Packard
Children’s Hospital, Stanford University School of Medicine, 725 Welch
Rd, Stanford, CA 94305-5654; and Quantitative Sciences Unit (R.L.) and
Department of Pediatrics, Division of Hematology/Oncology (S.L.S., A.P.,
H.E.D.L.), Stanford University School of Medicine, Stanford, Calif
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MRI Diagnosis of Clival Cancer and Sixth Nerve Palsy. J Neuroophthalmol 2023; 43:126-130. [PMID: 35830685 DOI: 10.1097/wno.0000000000001655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Imaging diagnosis of clival cancer may be difficult, in part because of normal variation in marrow signal with aging. Identifying whether clival cancer has damaged the sixth cranial nerve is a further challenge because minimal clival abnormalities could impinge on the nerve, which travels very close to the clivus. METHODS Two neuroradiologists, who were unaware of previous imaging and clinical diagnoses, reviewed MRI studies of 25 patients with cancer but no clival involvement and no sixth nerve palsy, 24 patients with clival cancer but without sixth nerve palsy, and 31 patients with clival cancer and sixth nerve palsy. The radiologists were tasked with determining whether there was clival cancer, whether there was a sixth nerve palsy and its laterality, and with indicating the pulse sequences used to make those determinations. RESULTS Both neuroradiologists correctly identified all 25 cases with a normal clivus. In about half of those cases, they depended on finding a homogeneously bright marrow signal; in the remaining cases, they excluded cancer by determining that the clivus was not expanded and that there were no focal signal abnormalities. Both neuroradiologists correctly identified clival cancer in 54 (98%) of the 55 cases with and without sixth nerve palsy. In doing so, they relied mostly on clival expansion but also on focal signal abnormalities. Both neuroradiologists were at least 80% correct in identifying a sixth nerve palsy, but they often incorrectly identified a palsy in patients who did not have one. When there was a one-sided signal abnormality or the clivus was expanded in one direction, both neuroradiologists were accurate in identifying the side of the sixth nerve palsy. CONCLUSION Current MRI pulse sequences allow accurate differentiation of a normal from a cancerous clivus. When the marrow signal is not homogeneously bright in adults, cancer can be diagnosed on the basis of clival expansion or focal signal abnormalities. MRI is less accurate in predicting the presence of a sixth nerve palsy. However, the side of a unilateral palsy can be predicted when the clivus is clearly expanded in one direction or there is a focal signal abnormality on one side.
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Bao H, He X, Li X, Cao Y, Zhang N. Magnetic resonance imaging study of normal cranial bone marrow conversion at high altitude. Quant Imaging Med Surg 2022; 12:3126-3137. [PMID: 35655838 PMCID: PMC9131338 DOI: 10.21037/qims-21-740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 03/11/2022] [Indexed: 08/29/2023]
Abstract
BACKGROUND To use conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) to investigate the effects of long-term hypoxia on cranial bone marrow conversion in healthy people at high altitudes. METHODS A total of 1,130 individuals were selected from altitudinal areas of 2,000-3,000, 3,100-4,000, and >4,100 m. Each altitude range was divided into 5 age groups: 0-5, 6-14, 15-29, 30-49, and ≥50 years. Firstly, cranial bone marrow typing of the participants in each altitude range was performed on sagittal T1-weighted images (T1WI) according to the average diploe thickness and signal intensity of the normal skull, and the relationship between bone marrow conversion and age was analyzed. Secondly, the apparent diffusion coefficient (ADC) values of the frontal bone, parietal bone, occipital bone, and temporal bone were measured in the DWI post-processing workstation and statistical methods were used to analyze whether different altitudinal gradients and long-term hypoxic environment had any effect on cranial bone marrow conversion. RESULTS There was a positive correlation between bone marrow type and age in the healthy populations at all 3 levels of altitude (P<0.05). The average thickness of the cranial diploe also positively correlated with age (P<0.05); in the age ranges of 30-49 and ≥50 years, the ADC values of the occipital and temporal bone marrow positively correlated with increasing altitude (P<0.05). CONCLUSIONS The cranial bone marrow of normal people at high altitudes changes from Type I to Type IV with increasing age and under the influence of long-term chronic hypoxia. The bone marrow of the occipital and temporal bones of healthy people aged 30-49 and ≥50 years showed erythromedularization during the process of Type III and IV bone marrow conversion.
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Affiliation(s)
| | | | - Xiaoguang Li
- Department of Medical Imaging Center, Qinghai University Affiliated Hospital, Xining, China
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Attri G, Maurya VP, Srivastava AK, Behari S, Bhaisora KS, Sardhara J, Verma PK, Nazar AH, Jaiswal S. Calvarial Lesions: A Tertiary Centre's Experience Over Fifteen Years. Neurol India 2021; 69:650-658. [PMID: 34169863 DOI: 10.4103/0028-3886.319236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The human calvaria harbors a variety of pathology and majority of them are incidentally noticed as painless swelling. The aim of the present study is to describe the histopathological subtypes of calvarial lesions, their management and factors affecting their surgical outcome at a tertiary care referral center. Material and Methods All patients who underwent excision of the calvarial lesions over the last 15 years (from January 2005 to July 2019) were included in this study. Patients having calvarial pathology of infective origin and recurrent lesions were excluded. Any patient with multiple calvarial lesions who have been operated more than one time for same histopathological diagnosis was counted as one patient. We studied Karnofsky Performance Status (KPS) scores and radiological changes at 3-month follow up. Results Total 65 patients were recruited in this retrospective observational study. The median age of patients in the study was 29 years (range: 8 years to 68 years). Fibrous dysplasia 20 (30.7%) was the commonest lesion while metastatic thyroid carcinoma 3 (4.6%) was the most common malignant pathology. Complete excision was performed in 51 (78.5%) of patients while in 14 (21.5%) cases, subtotal or near total decompression were achieved. After three months of surgery, there was significant improvement in the KPS score (P < 0.00001). Duration of follow up ranges from 6 months to 5 years with 4 mortality in the study. Conclusions Most of the calvarial tumors were benign and surgically addressable. The malignant lesions were scattered with diverse underlying pathology and required individualized holistic approach.
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Affiliation(s)
- Gagandeep Attri
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ved Prakash Maurya
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Arun Kumar Srivastava
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay Behari
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kamlesh Singh Bhaisora
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Jayesh Sardhara
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Pawan Kumar Verma
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Aftab Hasan Nazar
- Department of Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sushila Jaiswal
- Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Cao W, Liang C, Gen Y, Wang C, Zhao C, Sun L. Role of diffusion-weighted imaging for detecting bone marrow infiltration in skull in children with acute lymphoblastic leukemia. Diagn Interv Radiol 2017; 22:580-586. [PMID: 27763327 DOI: 10.5152/dir.2016.15167] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE We aimed to determine whether diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurement can detect skull bone marrow infiltration in newly diagnosed acute lymphoblastic leukemia (ALL) children before therapy and normalization in complete remission after treatment. METHODS Fifty-one newly diagnosed acute lymphoblastic leukemia (ALL) patients and 30 healthy age-matched subjects were included. Cranial magnetic resonance imaging (MRI) scans were reviewed, and skull marrow ADC values were compared before treatment and in complete remission after therapy. RESULTS Skull marrow infiltration, manifested with abnormal DWI signals, was present in 37 patients (72.5%) before treatment. Of these, 23 (62.2%) showed scattered signal abnormalities and 14 (37.8%) showed a uniform abnormal signal pattern. Compared with the control group, ADC was significantly decreased in patients with ALL. DWI signal intensity and ADC normalized in patients with complete remission. CONCLUSION DWI is a useful and noninvasive tool for detecting skull infiltration in ALL children before treatment and normalization at complete remission after therapy, and it is superior to conventional MRI in terms of conspicuity of these lesions. DWI could be used as an MRI biomarker for evaluation of treatment in ALL children.
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Affiliation(s)
- Weiguo Cao
- Graduate College, Southern Medical University, Guangdong General Hospital, Guangzhou, China; Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China.
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Yoshida T, Urikura A, Shirata K, Nakaya Y, Terashima S, Hosokawa Y. Image quality assessment of single-shot turbo spin echo diffusion-weighted imaging with parallel imaging technique: a phantom study. Br J Radiol 2016; 89:20160512. [PMID: 27452269 DOI: 10.1259/bjr.20160512] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the image quality and apparent diffusion coefficient (ADC) values of single-shot turbo spin echo (TSE) diffusion-weighted (DW) images obtained using a parallel imaging (PI) technique. METHODS All measurements were performed on a 3.0-T whole-body MRI system and 32-channel phased-array coil. Signal-to-noise ratio (SNR) and ADC values were measured with a DW imaging (DWI) phantom comprising granulated sugar and agar. The SNRs were calculated using a subtraction method and compared among TSE-DW images at acceleration factors (AFs) of 1-4. Image blur was visually assessed on TSE-DW images of a pin phantom at AFs of 1-4. The ADC values were calculated using DW images with b = 0 and 1000 s mm(-2). The ADC values of TSE-DW images and echo-planar imaging EPI-DW images were compared. RESULTS The SNRs decreased as AFs increased, despite selecting the shortest echo time. A lower AF caused increased image blur in the phase-encoding direction. The ADC values of TSE-DWI tended to be lower than those of EPI-DWI, and AFs of 3 and 4 yielded variable ADC values on TSE-DW images. CONCLUSION TSE-DWI with an AF of 3 or 4 yielded reduced SNRs; in addition, the image noise and artefacts associated with PI technique may have affected ADC measurements, despite improving image blur in the phase-encoding direction. ADVANCES IN KNOWLEDGE Optimizing the imaging parameters of TSE-DWI is useful for providing good image quality and accurate ADC measurements.
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Affiliation(s)
- Tsukasa Yoshida
- 1 Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan.,2 Department of Radiation Science, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Atsushi Urikura
- 1 Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kensei Shirata
- 1 Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoshihiro Nakaya
- 1 Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shingo Terashima
- 3 Department of Radiological Life Sciences, Division of Medical Life Sciences, Hirosaki University, Hirosaki, Japan
| | - Yoichiro Hosokawa
- 3 Department of Radiological Life Sciences, Division of Medical Life Sciences, Hirosaki University, Hirosaki, Japan
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Wang T, Wu X, Cui Y, Chu C, Ren G, Li W. Role of apparent diffusion coefficients with diffusion-weighted magnetic resonance imaging in differentiating between benign and malignant bone tumors. World J Surg Oncol 2014; 12:365. [PMID: 25432796 PMCID: PMC4265400 DOI: 10.1186/1477-7819-12-365] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 11/18/2014] [Indexed: 01/08/2023] Open
Abstract
Background Benign and malignant bone tumors can present similar imaging features. This study aims to evaluate the significance of apparent diffusion coefficients (ADC) in differentiating between benign and malignant bone tumors. Methods A total of 187 patients with 198 bone masses underwent diffusion-weighted (DW) magnetic resonance (MR) imaging. The ADC values in the solid components of the bone masses were assessed. Statistical differences between the mean ADC values in the different tumor types were determined by Student’s t-test. Results Histological analysis showed that 84/198 (42.4%) of the bone masses were benign and 114/198 (57.6%) were malignant. There was a significant difference between the mean ADC values in the benign and malignant bone lesions (P <0.05). However, no significant difference was found in the mean ADC value between non-ossifying fibromas, osteofibrous dysplasia, and malignant bone tumors. When an ADC cutoff value ≥1.10 × 10−3 mm2/s was applied, malignant bone lesions were excluded with a sensitivity of 89.7%, a specificity of 84.5%, a positive predictive value of 82.6%, and a negative predictive value of 95.3%. Conclusions The combination of DW imaging with ADC quantification and T2-weighted signal characteristics of the solid components in lesions can facilitate differentiation between benign and malignant bone tumors.
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Affiliation(s)
| | | | | | | | | | - Wenhua Li
- Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China.
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Ginat DT, Mangla R, Yeaney G, Ekholm S. Diffusion-weighted imaging of skull lesions. J Neurol Surg B Skull Base 2014; 75:204-13. [PMID: 25072014 PMCID: PMC4078190 DOI: 10.1055/s-0034-1371362] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Accepted: 11/03/2012] [Indexed: 12/16/2022] Open
Abstract
Diffusion-weighted imaging can increase the conspicuity of skull lesions and be applied toward noninvasive differentiation of malignant from benign lesions. Malignant skull lesions generally display lower diffusivity than benign lesions, although there are exceptions, and clinical parameters and conventional imaging modalities should also be considered in the evaluation of skull lesions. Nevertheless, in some instances diffusion-weighted imaging (DWI) can be used for problem solving when conventional imaging features are indeterminate, such as with skull base involvement by nasopharyngeal carcinoma versus osteomyelitis. In addition, DWI may be useful for monitoring treatment effects. The use of readout segmented technique, parallel imaging, multishot acquisition, turbo spin-echo DWI, diffusion tensor imaging, and higher field strengths can improve image quality. The feasibility of implementing DWI for characterizing skull lesions, the DWI findings of benign and malignant skull lesions, and technical considerations are discussed in this article.
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Affiliation(s)
- Daniel T. Ginat
- Department of Radiology, University of Chicago Medical Center, Chicago, Illinois, United States
- Address for correspondence Daniel T. Ginat, MD, MS Department of Radiology, University of Chicago Medical Center5841 South Maryland Avenue Chicago, IL 60637United States
| | - Rajiv Mangla
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, United States
| | - Gabrielle Yeaney
- Department of Pathology, University of Rochester Medical Center, Rochester, New York, United States
| | - Sven Ekholm
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, United States
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Budin F, Hoogstoel M, Reynolds P, Grauer M, O'Leary-Moore SK, Oguz I. Fully automated rodent brain MR image processing pipeline on a Midas server: from acquired images to region-based statistics. Front Neuroinform 2013; 7:15. [PMID: 23964234 PMCID: PMC3741535 DOI: 10.3389/fninf.2013.00015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 07/23/2013] [Indexed: 11/13/2022] Open
Abstract
Magnetic resonance imaging (MRI) of rodent brains enables study of the development and the integrity of the brain under certain conditions (alcohol, drugs etc.). However, these images are difficult to analyze for biomedical researchers with limited image processing experience. In this paper we present an image processing pipeline running on a Midas server, a web-based data storage system. It is composed of the following steps: rigid registration, skull-stripping, average computation, average parcellation, parcellation propagation to individual subjects, and computation of region-based statistics on each image. The pipeline is easy to configure and requires very little image processing knowledge. We present results obtained by processing a data set using this pipeline and demonstrate how this pipeline can be used to find differences between populations.
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Affiliation(s)
- Francois Budin
- Neuro Image Research and Analysis Laboratories, Department of Psychiatry, University of North Carolina Chapel Hill, NC, USA
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12
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Koo JH, Kim CK, Choi D, Park BK, Kwon GY, Kim B. Diffusion-weighted magnetic resonance imaging for the evaluation of prostate cancer: optimal B value at 3T. Korean J Radiol 2012; 14:61-9. [PMID: 23323032 PMCID: PMC3542304 DOI: 10.3348/kjr.2013.14.1.61] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 08/02/2012] [Indexed: 01/08/2023] Open
Abstract
Objective To retrospectively determine the optimal b value of diffusion-weighted imaging (DWI) for predicting the presence of localized prostate cancer, and to evaluate the utility of DWI under different b values in differentiating between cancers and benign prostatic tissues. Materials and Methods Eighty patients with suspected prostate cancer underwent MRI including DWI at 3T, followed by radical prostatectomy. DWI was examined under different b values. Apparent diffusion coefficient (ADC) maps were generated by using b = 0, and other b values of 300, 700, 1000 or 2000 s/mm2. For predicting the presence of cancers, four different ADC maps were analyzed independently by two blinded readers. ADCs were measured in benign and malignant tissues. Results For predicting the presence of 110 prostate cancers, the sensitivity and area under the curve (AUC) for an experienced reader was significantly greater at b = 1000 (85% and 0.91) than b = 300, 700 or 2000 s/mm2 (p < 0.01). For a less-experienced reader, the AUC was significantly greater at b = 700, 1000 or 2000 than b = 300 s/mm2 (p < 0.01). Mean ADCs of the cancers in sequence from b = 300 to 2000 s/mm2 were 1.33, 1.03, 0.88 and 0.68 × 10-3 mm2/s, which were significantly lower than those of benign tissues (p < 0.001). Conclusion The optimal b value for 3T DWI for predicting the presence of prostate cancer may be 1000 s/mm2.
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Affiliation(s)
- Ji Hyun Koo
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
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Normal cranial bone marrow MR imaging pattern with age-related ADC value distribution. Eur J Radiol 2011; 80:471-7. [DOI: 10.1016/j.ejrad.2010.09.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 06/01/2010] [Accepted: 09/14/2010] [Indexed: 11/22/2022]
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14
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Biffar A, Dietrich O, Sourbron S, Duerr HR, Reiser MF, Baur-Melnyk A. Diffusion and perfusion imaging of bone marrow. Eur J Radiol 2010; 76:323-8. [DOI: 10.1016/j.ejrad.2010.03.011] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Accepted: 03/11/2010] [Indexed: 12/23/2022]
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15
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Gutzeit A, Doert A, Froehlich JM, Eckhardt BP, Meili A, Scherr P, Schmid DT, Graf N, von Weymarn CA, Willemse EMM, Binkert CA. Comparison of diffusion-weighted whole body MRI and skeletal scintigraphy for the detection of bone metastases in patients with prostate or breast carcinoma. Skeletal Radiol 2010; 39:333-43. [PMID: 20205350 DOI: 10.1007/s00256-009-0789-4] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To prospectively compare the diagnostic accuracy of diffusion-weighted whole body imaging with background whole body signal suppression (DWIBS) with skeletal scintigraphy for the diagnosis and differentiation of skeletal lesions in patients suffering from prostate or breast cancer. MATERIAL AND METHODS A diagnostic cohort of 36 patients was included in skeletal scintigraphy and 1.5 T DWIBS MRI. Based on morphology and signal intensity patterns, two readers each identified and classified independently, under blinded conditions, all lesions into three groups: (1) malignant, (2) unclear if malignant or benign and (3) benign. Finally, for the definition of the gold standard all available imaging techniques and follow-up over a minimum of 6 months were considered. RESULTS Overall, 45 circumscribed bone metastases and 107 benign lesions were found. DWIBS performed significantly better in detecting malignant skeletal lesions in patients with more than 10 lesions (sensitivity: 0.97/0.91) compared to skeletal scintigraphy (sensitivity: 0.48/0.42). No statistical difference could be found between DWIBS (0.58/0.33) and skeletal scintigraphy (0.67/0.58) in the sensitivity values for malignant skeletal lesions in patients with less than 5 lesions. For benign lesions, scintigraphy scored best with a sensitivity of 0.93/0.87 compared to 0.20/0.13 for DWIBS. Interobserver agreement with Cohen's kappa coefficient was calculated as 0.784 in the case of scintigraphy and 0.663 for DWIBS. CONCLUSION With respect to staging, in prostate and breast carcinoma, the DWIBS technique is not superior to skeletal scintigraphy, but ranks equally. However, in the cases with many bone lesions, markedly more metastases could be discovered using the DWIBS technique than skeletal scintigraphy.
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Affiliation(s)
- Andreas Gutzeit
- Department of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland.
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Nakanishi K, Gutzeit A. Evaluation of Malignant Bone Disease Using DW-MRI. MEDICAL RADIOLOGY 2010. [DOI: 10.1007/978-3-540-78576-7_13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Role of diffusion-weighted MRI in the detection of early active sacroiliitis. AJR Am J Roentgenol 2008; 191:980-6. [PMID: 18806131 DOI: 10.2214/ajr.07.3865] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study proposed to evaluate the value of diffusion-weighted MRI (DWI) to detect active inflammatory changes in the sacroiliac joints of patients with early axial spondyloarthritis (also spelled spondylarthritis). SUBJECTS AND METHODS Forty-two patients with chronic low back pain underwent clinical and MRI evaluation for axial spondyloarthritis or early ankylosing spondylitis. STIR, contrast-enhanced T1-weighted, fat-saturated T2-weighted, and diffusion-weighted (b values: 100, 600, 1,000 s/mm(2)) images were obtained. The presence of subchondral bone marrow edema, subchondral fatty marrow infiltration, or contrast enhancement in the sacroiliac joints or adjacent enthesitis sites was considered a marker for active inflammatory changes. All MRI sequences were evaluated for the presence of acute inflammatory changes and inter- and intrarater reliability of the sequences. Mean apparent diffusion coefficient (ADC) values of diffusion-weighted images were calculated from normal and involved iliac and sacral bones of sacroiliac joints. RESULTS ADC values measured from the lesions at b values of 1,000 and 600 s/mm(2) in patients with sacroiliitis (n = 13) were significantly higher than values measured from iliac and sacral bones in patients with low back pain of mechanical origin (n = 29). DWI showed sensitivity for detecting acute lesions in early sacroiliitis similar to that of T1-weighted gadolinium images (area under the curve, 0.843-0.971). Intra- and interrater reliability of DWI was acceptable. CONCLUSION DWI is a sensitive, fast sequence and does not require a contrast agent, which makes it a good and cost-effective alternative for imaging sacroiliac joints. DWI also offers the possibility of quantifying diffusion coefficients of the lesions, which helps to discriminate between normal and involved subchondral bone.
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